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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 070213664
Report Date: 10/31/2019
Date Signed: 10/31/2019 11:27:04 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:BARKSDALE, ELLASTINEFACILITY NUMBER:
070213664
ADMINISTRATOR:BARKSDALE, ELLASTINEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 640-0032
CITY:RICHMONDSTATE: CAZIP CODE:
94806
CAPACITY:14CENSUS: 6DATE:
10/31/2019
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Ellastine BarksdaleTIME COMPLETED:
11:30 AM
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Licensing Program Analyst (LPA) Paul Petersen conducted an unannounced Plan of Correction site inspection for this facility at 1030. LPA met with licensee, Ellastine Barkdale. Also present were licensee's husband, Albert Barksdale, and six children in care consisting of two infants and four preschool age. The facility is within ratio and capacity. LPA and licensee reviewed the ratio and capacity requirements for a large family child care home and LPA provided licensee with the info graphic regarding large FCCH ratio and capacity. The deficiency cited on 10/17/19 for capacity was cleared during this inspection. There are no remaining deficiencies outstanding.

During this visit the following change to on-limits/off-limits areas was made; the outdoor patio area is now off limits to children in care due to repair of the fence. Licensee will contact LPA when the fence is complete and the area is ready to be returned to on-limits.

There were no deficiencies cited during this inspection. A copy of this report as well as a copy of the notice of site visit were printed and provided. The notice of site visit is to remain posted for 30 days.
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Paul PetersonTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 10/31/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/31/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
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